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05983 (SFD)Twy�eI P.O. BOX 1504 No. 05983 Bu8-105 54.927ilding CCALIFORNIA 92253 Address �"'Q27 Southern: iii LA QUINTA Owner _ .... . Sunrise Co. Mailing BUILDING: TYPE CONST.• OCC: GRP. Address 75-005 Country Club A.P.,Number, M West" City Zip Tel. Y' y ?*D. 92260 56 282 Legal Description Contractor Project Description PhAse 19B Plan 3 $ am Address . s City Zip Tela State Lie. City &,Classif. 288130 Lic. # 328 S Ft. S i e• 28216,Stories No. No. Dw. Units - Arch., Engr:, New(9 Add'❑ Alter ❑ Repair ❑ Demolition ❑ Designee Address Tel. City Zip State Lic: # LICENSED CONTRACTOR'S DECLARATION I. hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect t " SIGNATURE DATE OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the.Contractors License Law for the following Estimated Valuation 194,692.00 reason: (Sec. 7031.5,8usiness and Professions Code: Any city or county which requires a permit to construct,. 'after, improve, demolish, or repair any structure, prior to its issuance also requlres the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT AMOUNT the Drovfslons of the Contractors license Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for. a permit Plan Chk. Dep. ' subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. !3 �• ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work4 and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 97"2.�S1. Professions Code." The CortUactoes license Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees,Mech. 6 u' provided that such improvements are not intended or offered for sale. If, however, the building Electrical ><4+° or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale.) . Plumbing s .❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law S.M.I. 13.65 ' does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Sea_ g, ti P.C. for this reason - Driveway Enc. Date owner Infrastructure- WORKERS' COMPENSATION DECLARATION ;*eixe I hereby affirm that 1 have a certificate of consent to self-insure, or a certificate of Worker's Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.) Policy No Company O Copy is filed with the city. ❑ Certified copy is hereby furnished. . TOTAL �6 i . k,Ti2 r;!`�-✓L'' � I ^il.- . .. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS Ft ►' 1 ;F a,c+ax s t t.:r > it �.x "k'4. zaP3 vim: r•... lj1 (This section need not be completed it the permit is for one hundred dollars (8100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in arty manner so as to become subject to the Workers' Compensation Laws of California Date —L—owner NOTICE TO APPL1CAW. B, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Comply with such Provisions Oftnispermit shall bedeemed revoked. Minimum Setback Distances: ' Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued- (Sec. 3097, CivilCode.) Side Setback from Property Line " Lenders Name FINAL DATE INSPECTOR Lenders Address This is a building permit when property filled but, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. 6-19-89 I certify that I have read this application and state that the above information is correct. Issued by: Date Permit I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives .of this city to enter the above-. r mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, State zi STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SACK OLIND PLUMBING UNDERGROUND CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS HEATING (ROUGH) STORAGE TANK FOR YARD SPKLR SYSTEM 2N0 FL SQ. FT. ® DUCT WORK ROCK STORAGE REINF. j MOBILEHOME SVC. BAR SINK POR. SQ. FT. OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® GROUT WATER HEATER SERVICE FINAL INSP. DRAINAGE PIPING CARP. SO. FT. ® WATER SYSTEM GRADING cu. yd. $ plus x$ _$ DRINKING FOUNTAIN. WALL SQ. FT. 'MING FINAL INSP. O FING �� O � � ^ /fJ URINAL SO. FT. REMARKS: ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER SPARK ARRESTOR GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAR. FIREWALL LAUNDRY TRAY AIR HANDLING UNIT CFM T // KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/. c SEWAGE DISPOSAL SQ.FT.GAR ® V/ac HOUSE SEWER FENCE FINAL GASPIPING PERMIT FEE PERMIT FEE [PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SACK OLIND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA RADE ROU PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FOR ER OR SEPTIC ROUGH WIRING DUCT WORK ROCK STORAGE REINF. j GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. I L INSP. .- 'MING FINAL INSP. O FING �� O � � ^ /fJ 1( 2 C�'C�/ / REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL T // MESH NSULATION/SOUND�� 107 FINISH GRADING FINAL INSPECTION - CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATOR'°SIINITIALS GARDEN WALL FINAL L